Model for Enhancing Protective Factors Against Suicide in Depressive Disorder Patients: A case study of Lablae District, Uttaradit Province

Abstract

Background: Patients with depression are at risk of suicide. Suicidal behavior occurs when 1) they have risk factors and triggers, 2) their barriers and surveillance fail, and 3) their protective factors are weak. The key to solving suicide problems is those who have life crises or those who have committed suicide. If they have strong protective factors, they will be able to prevent suicidal thoughts and actions.

Aims: 1) Study the situation and guidelines for strengthening protective factors against suicide in patients with depression, 2) To create and examine a model for strengthening protective factors against suicide in patients with depression, 3) Experiment and study the results of using the model for strengthening protective factors against suicide in patients with depression, 4) Evaluate satisfaction with the model for strengthening protective factors against suicide in patients with depression.

Methods: This study is a 4-step research and development study, consisting of 1) Studying the situation and guidelines for creating the model, 2) Creating and examining the quality of the model, 3) Experimenting and studying the results of using the model, and 4) Studying satisfaction with using the model. Step 1 The sample group is a multidisciplinary team with at least 1 year of experience in caring for patients with depression and suicide, and 18 public health volunteers, selected purposively. The instruments used are a semi-structured interview form for focus group discussions and a voting form. To draft the model, Step 2: The sample group consisted of 269 stakeholders and patients with depression, purposively selected, and 5 experts. The instruments used were factor analysis and assessment of opinions based on the model's components. Step 3: The sample group consisted of 30 patients with depression, purposively selected, and randomly assigned to be an experimental group (15 patients) and a control group (15 patients). The experimental group participated in the activity of the model to strengthen protective factors against suicide in patients with depression, which was created, 7 times. After the activity, the control group received regular services at the hospital. The instruments used were the model to strengthen protective factors against suicide in patients with depression, the Thai happiness assessment form, the 9-question depression assessment form, and the 8-question suicide risk assessment form. Step 4: The sample group consisted of the same group as in Step 1 and Step 3, the experimental group, totaling 33 people. The instruments used were the satisfaction assessment form for the model. Data were analyzed using mean, standard deviation, t-test, and Mann and Whitney's test.

Results: of the research found that 1) Patients with depression have a very high level of physical health protection factors, a low level of financial health protection factors, and other protective factors are at a moderate level. The level of opinions on the effect of protective factors against suicide in depressed patients was the most happiness. The approach to strengthen protective factors against suicide in depressed patients found that the Four Noble Truths according to Buddhist psychology was appropriate to draft the model. 2) The result of the model construction to strengthen protective factors against suicide in depressed patients had 5 main components (principles, objectives, content, process, and measurement and evaluation). There were sub-components of the process part for trial use as follows: (1) searching for patients' thoughts, emotions, and feelings (2) letting patients know their thoughts, emotions, and feelings (3) changing patients' thoughts, attitudes, and behaviors. The evaluation results were at a good level of appropriateness. 3) The result of the trial use of the model found that the average score of happiness in the experimental group was significantly higher than the control group at a statistical level of .05. The average score of depression and the average score of suicide risk in the experimental group was significantly lower than the control group at a statistical level of .05. 4) The evaluation of satisfaction with the model was at a good level.

Conclusion: The model of enhancing protective factors against suicide in patients with depression is at a good level of appropriateness. It can be used to enhance protective factors against suicide in patients with depression, resulting in increased happiness, decreased depression, and risk of suicide.