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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 72-76

Assessing the risk factors of suicide among adolescents and evaluating the knowledge on suicide prevention at Goalpara, Assam


1 Sister Tutor, GNM Training School, Goalpara, Assam, India
2 Principal, Gispur institute of Nursing, Guwahati, Assam, India

Date of Web Publication21-Jan-2020

Correspondence Address:
Mrs. Rita Moni Sharma
GNM Training School, Goalpara, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IOPN.IOPN_24_19

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  Abstract 


Background of the Study: A study was conducted to assess the risk factors of suicide among adolescents and evaluate the knowledge on suicide prevention in selected colleges of Goalpara district, Assam. Aims: Aims of the study were to reduce suicide rate among adolescents by creating awareness, provide knowledge on risk factors of suicide and suicide prevention. Objectives: 1.To assess the risk factors of suicide among adolescents in control and experimental group before intervention. 2.To assess the knowledge on suicide prevention among adolescents in control and experimental group before and after intervention. 3.To evaluate the effectiveness of structured teaching programme on increasing knowledge suicide prevention among adolescents of experimental group. Materials and Methods: It was a quantitative approach, quasi experimental study with pre test-post test and control group design. Purposive non random sampling technique was used to select the sample. The study was conducted in two colleges with 80 students, 40 in each control and experimental group. Adolescents selected for the study were the students between the age group of 16-19 years and were studying higher secondary standard. Self administered structured questionnaire was used which consist of three part related to socio-demographic data, risk factors of suicide and knowledge on suicide prevention. Structured teaching programme was conducted to the experimental group which included knowledge on suicide prevention. Results: There was significant difference ('t'=14.607, p=0.000) between control and experimental group in the post test of knowledge on suicide prevention. The overall post test knowledge score on suicide prevention showed that majority of the respondents acquired good knowledge in experimental group. The results indicated that adolescents suicide can be prevented by increasing knowledge, awareness and developing positive attitude.

Keywords: Risk factors knowledge, suicide, suicidal behaviours, suicide preventio


How to cite this article:
Sharma RM, Majhi TK. Assessing the risk factors of suicide among adolescents and evaluating the knowledge on suicide prevention at Goalpara, Assam. Indian J Psy Nsg 2019;16:72-6

How to cite this URL:
Sharma RM, Majhi TK. Assessing the risk factors of suicide among adolescents and evaluating the knowledge on suicide prevention at Goalpara, Assam. Indian J Psy Nsg [serial online] 2019 [cited 2020 Feb 22];16:72-6. Available from: http://www.ijpn.in/text.asp?2019/16/2/72/276347




  Introduction Top


Suicide is the act of intentionally causing one's own death. There is no single cause for suicide. It is a complex public health problem of global dimension. Conditions such as depression, anxiety, and substance problems, especially when unaddressed, increase the risk for suicide.[1],[2]

The World Health Organization (WHO) has defined “adolescents” as persons who belong to 10–19-year age group. Adolescence is one of the most rapid phases of human development. It is a stressful period of life with major changes including body and mind. Individual and the environment influence on the changes taking place during adolescence. Wisdom or the capacity for insight and judgment that is developed through experience within this period.[3]

Attempted suicide is defined as any act of self-damage carried out with the apparent intention of self-destruction; however, half-hearted, vague, and ineffective suicide attempt among adolescents is a major challenge. According to the American Academy of Pediatrics, attempted suicide among adolescent males 15–19 years old had a rate 6 times greater than the rate for females. The ratio of attempted suicides to completed suicides among adolescents is estimated to be 50:1–100:1, and the incidence of unsuccessful suicide attempts is higher among females than among males. Suicide affects young people from all races and socioeconomic groups although some groups seem to have higher rates than others.[1],[2],[4]

Suicidal behaviors are classified into three categories: suicide ideation, which refers to thoughts of engaging in behavior intended to end one's life; suicide plan, which refers to the formulation of a specific method through which one intends to die; and suicide attempt, which refers to engagement in potentially self-injurious behavior in which there is at least some intent to die.[5]

Risk factors are characteristics or conditions that increase the chance that a person may try to take their life. There are numerous factors can contribute to suicide, and that ultimately each suicide is caused by a highly unique, dynamic and complex interplay of genetic, biological, psychological and social factors.[6]

According to a WHO report, India has the highest suicide rate in the world for 15 to 29-year age group. During the year 2012, the suicide rate was 35.5 per 100,000 in this age group. Assam witnessed around 15,000 suicides in the past 5 years. According to the report of the National Crime Bureau of India, the rate of suicide in Assam in the year 2010 was 8.7 per lakh, and in the year 2012, it was 10.5. However stigma associated with suicide most cases are remain unreported.[7]

Sharma Rahul, Grover Vijay L, and Chaturvedi S assessed the risk factors of suicide in three schools and colleges at South Delhi, who found that 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.[8]

According to the Lok Sabha reply by H. G. Ahir, Minister of State for Home Affairs, on January 2, 2019, 9,474 students committed suicide in 2016 – almost 26 every day. Student suicides in the country have increased 52% from 17 every day (6248) in 2007 to 26 every day in 2016, data show. Around 75,000 students committed suicides in India between 2007 and 2016.[9]

Causes of suicidal distress include psychological, environmental, and social factors. Mental illness is the leading risk factor for suicide. Suicide risk factors vary with age, gender, and ethnic group. Suicide is a complex issue. Before prevention, risk factors of suicide should be identified. Suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, justice, law, defense, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide. Raising community awareness and breaking down the taboo is important for countries to make progress in preventing suicide.[10]


  Materials and Methods Top


It was a quantitative approach, quasi-experimental study with pretest–posttest and control group design. A nonrandom purposive sampling technique was used to select the sample. The study was conducted in two colleges with 80 students, 40 in each control and experimental group. Adolescents between the age groups of 16 and 19 years were studying higher secondary standard. A self-administered structured questionnaire was used which consists of three parts related to sociodemographic data, risk factors of suicide, and knowledge on suicide prevention. Sociodemographic data included age, gender, religion, educational status, parental education, and parental occupation area of living. Risk factors included psychological problems such as anxiety, depression, and feeling hopelessness, and family problems included communication gap among the family members, lack of support, and disturbed family environment. High-risk behaviors included suicidal thought, suicidal plan, and suicidal attempt. A structured teaching program was conducted to the experimental group which included knowledge on suicide prevention such as warning signs, role of parents, teachers, peers, and community. Ethical consent was obtained from higher education authority and college authority. Informed consent was taken before participation. The validity and reliability of the tools were established before their use. Descriptive and inferential statistics were used to accomplish the study objectives.


  Results Top


[Table 1] shows that in the control group, the mean percentage of family problems is 43.96% and the mean percentage of economic problems is 42.5%. It shows that majority, i.e., 43.96% of the participants, have family problem and 42.5% have economic problems. Then, 37.5% have physical problems, 34.1% have psychological problems, 31.56% have academic problems, 22.5% have negative peer relations, 15% have problems related to love affairs, 12.5% have family history of mental illness, 6.67% have problems related to sociocultural factors, 5.94% have high-risk behaviors (suicidal thoughts), and 2.5% have family history of substance abuse and sexual abuse.
Table 1: Mean, mean percentage, and standard deviation of aspect-wise risk factor scores in pretest for control and experimental groups (n=80)

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In the experimental group, the economic problems (mean percentage: 68.8%) and the family problems (mean percentage: 46%) are the main factors responsible for suicide. Other risk factors are academic problems (mean percentage: 38.75%), psychological problem (38.38%), problem related to love affairs (34.38%), physical problems (29.37%), family history of mental illness (25%), negative peer relations (24%), high-risk behaviors (10.94%), family history of substance abuse (10%), sociocultural factors (9.17%), and sexual abuse (2.5%).

On the basis of the risk, participants are classified into low-, moderately high-, and very high-risk groups.

[Figure 1] illustrates that in the control group, 47.5% of the respondents show low risk and 52.5% show moderately high risk (suicidal thought). In the experimental group, 75% of the respondents have moderately high risk (suicidal thought), 22.5% have low risk, and 2.5% have very high risk (suicidal attempt).
Figure 1: Distribution of respondents as per level of risk in control and experimental groups

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[Table 2] indicates that the mean of the experimental and control groups in pretest are 9.68 and 9.28, respectively, mean difference 0.4 paired t = 0.670 and P = 0.505. There is no significant difference between the control and experimental groups in pretest knowledge score.
Table 2: Mean, standard deviation, mean difference, standard error of mean difference, and “t” value of pretest score of knowledge among control and experimental groups (n=80)

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[Table 3] indicates that there is a significant difference (t = 14.607, P = 0.000) between the experimental and control groups in posttest knowledge score on suicide prevention.
Table 3: Mean, standard deviation, mean difference, standard error of mean difference, and “t” value of posttest knowledge scores of control and experimental groups (n=80)

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[Figure 2] illustrates the level of knowledge among the adolescents on suicide prevention in the experimental and control groups. In the control group, 77.5% of the respondents have moderate knowledge in pretest, whereas 82.5% have moderate knowledge in posttest. In the experimental group, 72.5% of the respondents have moderate knowledge and 10% have adequate knowledge in pretest and 2.5% of the respondents have moderate and 97.5% have adequate knowledge on suicide prevention in posttest.
Figure 2: Distribution of respondents as per level of knowledge on suicide prevention in control and experimental groups

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  Discussion Top


Adolescence is the window period to enhance the knowledge on suicide prevention which is a major challenge for health-care delivery system. The study findings show that majority, i.e., 43.96% of the participants, have family problem and 42.5% have economic problems. Then, 37.5% have physical problems, 34.1% have psychological problems, 31.56% have academic problems, 22.5% have negative peer relations, 15% have problems related to love affairs, 12.5% have family history of mental illness, 6.67% have problems related to sociocultural factors, 5.94% have high-risk behaviors (suicidal thoughts), and 2.5% have family history of substance abuse and sexual abuse. In the experimental group, the economic problems (mean percentage: 68.8%) and the family problems (mean percentage: 46%) are the main factors responsible for suicide. Other risk factors are academic problems (mean percentage: 38.75%), psychological problem (38.38%), problem related to love affairs (34.38%), physical problems (29.37%), family history of mental illness (25%), negative peer relations (24%), high-risk behaviors (10.94%), family history of substance abuse (10%), sociocultural factors (9.17%), and sexual abuse (2.5%). On the basis of the risk, participants are classified into low-, moderately high-, and very high-risk groups that in the control group, 47.5% of the respondents show low risk and 52.5% show moderately high risk (suicidal thought). In the experimental group, 75% of the respondents have moderately high risk (suicidal thought), 22.5% have low risk, and 2.5% have very high risk (suicidal attempt). The study findings are correlated with the findings of another study which was conducted by Kwaku Oppong Asante et al. among the senior school students, which reveal that the prevalence of suicidal behaviors was 18.2% for suicidal ideation, 22.5% for suicidal plan, and 22.2% for suicidal attempt. Family problems, i.e., lack of support, loneliness, economic problems, psychological problems such as anxiety, uncontrolled emotion, physical abuse, and negative peer relations, are responsible for suicidal behaviors.[11]

The findings of the present study on effectiveness of structured teaching program revealed that a structured teaching module was effective for the students in improving knowledge on suicide prevention. It was evident from the significant gain in posttest knowledge scores as revealed by the paired t-test among the control and experimental groups. In the control group, 77.5% of the respondents have moderate knowledge in pretest, whereas 82.5% have moderate knowledge in posttest. In the experimental group, 72.5% of the respondents have moderate knowledge and 10% have adequate knowledge in pretest and 2.5% of the respondents have moderate and 97.5% have adequate knowledge on suicide prevention in posttest. The study findings are correlated with the study conducted by Arya Sandeep (2015) among 100 higher secondary students in Alwar, Rajasthan, which reveal that 49% had low knowledge, 41% had average knowledge, and 10% had adequate knowledge on suicide prevention.[12]


  Conclusion Top


The present study revealed that family problems (mean percentage: 43.96%) and economic problems (42.5%) in the control group are the main problems, whereas economic problems (mean percentage: 68.8%) and family problems (mean percentage: 46%) were the main risk factors in the experimental group. Other factors are psychological problems such as uncontrolled emotion, anxiety, feeling hopelessness problem related to love affairs, academic problem are also responsible for suicidal behaviours. In the knowledge aspect, in the control group, 82.5% have moderate knowledge in posttest, and in the experimental group, 2.5% of the respondents have moderate and 97.5% have adequate knowledge on suicide prevention in posttest score. The structured teaching module is found to be effective to increase the knowledge of the adolescents. However, to prevent risk factors, it is essential to enhance the knowledge of the family members and community on suicide prevention.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lalitha K. Mental Health and Psychiatric Nursing an Indian Perspective. New Delhi: V.M.G. Book House; 2008. p. 576.  Back to cited text no. 1
    
2.
American Foundation for Suicide Prevention. Risk Factor and Warning Signs. American Foundation for Suicide Prevention. Available from: http//www.afsp.org>. [Last accessed on 2014 Oct 16].  Back to cited text no. 2
    
3.
Adolescence. Available from: http//www.who.org/adolescence. [Last accessed on 2012 Oct 12].  Back to cited text no. 3
    
4.
American Academy of Pediatrics. Committee on adolescence: Suicide and suicide attempts in adolescents and young adults. Pediatrics 1988;81:322-4.  Back to cited text no. 4
    
5.
Bazrafshan MR, Sharif F, Molazem Z, Mani A. Exploring the risk factors contributing to suicide attempt among adolescents: A qualitative study. Iran J Nurs Midwifery Res 2016;21:93-9.  Back to cited text no. 5
    
6.
American Foundation for Suicide Prevention. Risk factor and Warning Signs. American Foundation for Suicide Prevention. http//www.afsp.org>. [Last accessed on 2016 Sep 28].  Back to cited text no. 6
    
7.
Times of India. India has Highest Number of Suicides in the World: WHO. Times of India; 06 September, 2014. Available from: http://www.who.int/mental_health/prevention/suicide/suicideprevent/en. [Last accessed on 2014 Dec 18].  Back to cited text no. 7
    
8.
Sharma R, Grover VL, Chaturvedi S. Suicidal behavior amongst adolescent students in south Delhi. Indian J Psychiatry 2008;50:30-3.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
75,000 Students Committed Suicides in India between 2007 and 2016: Study. Business Standard; 2019. [Last accessed on 2017 Jun 15].  Back to cited text no. 9
    
10.
Van Heeringen K, editor. The Suicidal Process and Related Concepts. Chichester: John Wiley and Sons Ltd.; 2001. p. 136-59.  Back to cited text no. 10
    
11.
Asante KO, Kugbey N, Osafo J, Quarshie EN, Sarfo JO. The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana. Available from: http//www.ncbi.nln.nih.gov/pubmed. [Last accessed on 2016 Jan 04].  Back to cited text no. 11
    
12.
Sandeep A. Suicide: knowledge and attitude among higher secondary school adolescents in Alwar, Rajasthan. Int J Nurs Res 2015;(2)1.  Back to cited text no. 12
    


    Figures

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    Tables

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