Suicidality among Hong Kong nurses : prevalence and correlates

Abstract

According to the World Health Organization (WHO), in 2014 about 840,000 lives worldwide were lost to suicide. Suicide accounts for 1.5% of all deaths; it is the tenth leading causes of death worldwide. More significantly, suicide constituted 1.8% of the total disease burden, a figure estimated to rise to 2.4% by 2020. 61% of the world’s suicides take place in Asia, and suicide rates among middle-aged employed groups have apparently been on the rise in the last decade. A Danish study examined the risk of suicide in doctors, dentists, pharmacists, veterinary surgeons and nurses alongside that for teachers and the general population. Crude-age-and gender-adjusted-ratios (Relative Risk) were higher than teachersʼ for nurses, doctors and other medical occupational groups. The existing literature further suggests that suicide is in the top five causes of death for nurses of all ages and levels of seniority. Despite these facts, there remain few population-based studies of suicide among working-age professionals in Hong Kong. ii This thesis is primarily concerned to estimate the prevalence and examine the socio-economic and psychological correlates of suicidality among professional nurses in Hong Kong. It used a web-based self-administrative cross-sectional survey design. Data were collected in Hong Kong over a four-week period from October to November 2013. Statistical methods including descriptive analysis, univariate, bivariate and multivariate cumulative logit modelling and multivariate logistic regression were used to examine the weighted prevalence rates of past-year suicidality, past-week depression, anxiety and stress and its associated factors in nurses. A total of 850 nurses participated in the study. 14.9% of participants contemplated suicide while 2.9% had attempted suicide once or more in the past year. Women report suicidal thoughts or attempts more often than men. Having a religion, health disturbances, self-harm, depressive symptoms, poor self-perceived physical and mental health were significantly associated with nurses’ past-year suicidality. Nevertheless, religious bereaved people reported fewer depressive symptoms than the non-religious. Religion seems to be a moderator in thee terms between faith, bereavement and depression. The prevalence of depression, anxiety and symptoms of stress came in at 35.8%, 37.3%, and 41.1%. Chronic past-year illness and poor self-perceived mental health were significant correlates of past-week depression, anxiety and stress. Findings emerged also shows that three lifestyle factors (lack of sleep, not keeping up with hobbies and lack of entertainment) were significantly associated with depression. A total of 44.6% of the participants had encountered workplace violence in the preceding year. Verbal abuse/ bullying (39.2%) was the most common form of non-physical violence. The most common iii perpetrators of workplace violence were patients (36.6%) and their relatives (17.5%). Nonetheless, workplace violence was not significantly correlated with suicidality among Hong Kong nurses. The study shows that nurse professionals are at an elevated risk of developing psychiatric morbidity than the general population in Hong Kong. Hong Kong’s local health authority should put in place a raft of suicide prevention initiatives to foster mental wellness in the nursing profession. (482 words)published_or_final_versionSocial Work and Social AdministrationDoctoralDoctor of Philosoph