背景:关于自杀的研究很少关注保护因素。本系统评价的目的是评估保护因素与老年人自杀倾向降低之间关联的证据。
方法:首先,进行了范围审查,以确定相关术语,这些术语涉及针对自杀的各种保护因素。系统的审查,遵循PRISMA准则,然后选择15个保护因素(例如,感知控制,幸福和生活质量,生活满意度,生活的目的,弹性,应对,宗教信仰,希望,自我调节,归属感,重要的,积极的关系,社会支持,社会联系,和社会参与),在五个数据库中对每个因子进行单独搜索。如果参与者是60岁及以上的成年人,实证研究是合格的,以及研究是否报告了预测性统计分析。
结果:本综述共保留了70项研究。自杀意念是主要的结局指标(91%)。在所有保护因素和减少的自杀意念或行为之间始终观察到显着关联。特别是为了生活的目的,弹性,和积极的关系,表明这些是预防自杀的坚实组成部分。使用刻度,而不是一个单一的项目,测量保护因素(如生活满意度)更有效地捕捉关联.另一方面,无论是使用主观的研究,结果都是相似的(例如,归属感)或客观(例如,社会连通性)措施。
结论:保护因素与自杀意念呈负相关。改善保护因素对于晚期自杀预防和干预措施的发展至关重要,而不是仅仅关注风险因素。
BACKGROUND: Research on suicide rarely focuses on protective factors. The goal of this systematic
review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults.
METHODS: First, a scoping
review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic
review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience,
coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis.
RESULTS: A total of 70 studies were retained for the
review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures.
CONCLUSIONS: Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.