2021 Volume 70 Issue 2 Pages 174-185
Objectives: To evaluate the support program provided by public health centers (PHCs) of Osaka prefecture, and identify effective methods and their content that lead to improvements in the relationship between residents who attempted suicide and their supporters
Methods: This study was conducted in two stages. In the first stage, the hypothesis and outcome index of the intervention was decided using focus group interviews. In the second stage, the program was evaluated accordingly. Of the 192 individuals who attempted suicide and consented to participate in the program from April 2014 to June 2015 at 5 PHCs, the 113 subjects whose support period had ended were selected, and of these, the 102 subjects whose case records were available were included in the study. The research period was between October and December 2015. Data were extracted from the case records. After defining help-seeking behavior, trusting relationships, and dominance as components that influence the relationships of subjects with their supporters, each component of the relationship was quantified on a 0 to 4-point scale. A total score of 6 or more was considered as indicating that the subject had a positive relationship with the supporter. Logistic regression analysis was performed using the methods and content of the program as explanatory variables, and a post intervention increase in the number of supporters with whom the subject had a positive relationship with as the dependent variable.
Results: The average age of the participants was 40.7 years, and 67.6% were women. Adjusted odds ratios that were significant on logistic regression analysis were as follows. Regarding the methods, interviews with both the individual who attempted suicide and his/her family (13.33; 95% confidence interval [95%CI]: 2.44–72.81); regarding the content, among the psychological support for subjects, listening to his/her needs (5.87; 95%CI: 2.00–17.22), explanation of support strategies and consensus formation (5.69; 95%CI: 1.88–17.23), and psychological education (3.26; 95% CI: 1.13–9.36); and regarding support for access to medical care, support for the continuation of treatment (4.72; 95%CI: 1.42–15.71). For all 5 subjects who received support to undergo treatment and to continue treatment, there was an increase in the number of supporters with whom they had a positive relationship.
Conclusion: The hypothesis and outcome index defined in our study was appropriate for individuals who attempted suicide. Our results indicated the importance of interviews with both the subject and the family, shared decision-making with the subject, and the need for continuous and careful support. The next step is qualitative evaluation regarding the relationship between individuals who attempted suicide and their supporters, and comparative evaluation using controls.
