The Factors Associated with the Caregivers of Suicidal Patients Stress, Attitude and Ability: A Path Analysis

Purpose: The purpose of this study was to examine the extent of caring stress of caregiver has direct/indirect effects on suicide care ability and suicidal attitude.

Methods: This is a cross-section correlational study.  We recruited 164 caregivers of suicidal patients. The inclusion criteria included: primary caregiver of suicidal patient, at least 18 years old, and no obvious mental impairment. All the participants were recruited from a Suicide Prevention Center and two psychiatric hospitals. There were 3 instruments administered to the participants: the Caring Stress Scale (CSS), the Suicidal Attitudes Scale (SAS), and the Suicidal Caring Ability Scale (SCAS). Data was analyzed by using SPSS and AMOS 19.0.  Bivariate analyses include correlation, t test, and analysis of variance. Path analysis is employed using structural equation modeling (SEM) approach to analyze the relationships among caregiving stress, attitude, and ability toward caring for suicidal patients. Data were collected in 2009 and 2010.

 

Results: The average age of the participants was 43.9 years (SD =13.84). The majority of participants had religious beliefs (n=132, 80.5%), lived with suicidal patients (n=127, 77.4%). More than half of participants were female (n=101, 61.6%), married (n=89, 54.3%), working more than 20 hours per week (n=93, 56.7%). The results of bivariate analyses indicated age and suicidal attitude was negatively  correlated (r = -.16, P = .048), suggesting the older of caregivers, the less positive attitude toward suicidal patients. Female caregivers had higher level of stress than male caregivers (83.1 vs. 77.0, P = .02), but no difference in suicidal attitude and suicide care ability. Caring stress was treated as an exogenous variable and suicide care ability and suicidal attitude were endogenous variable. In the final model, being female caregiving status  increased the level of caring stress (b = .20, P = .02). Caring stress had a direct effect on suicidal attitude (b = .27, P = .01), but not on suicide care ability (b = .15, P = .11). The association between suicidal attitude and suicide care ability was significant (r = .65, P < .001). Results indicated that female caregiver would have higher levels of caring stress, caring stress could prompt the attitude toward caring for suicidal patients, and positive attitude toward suicidal patients would be associated with ability to care for suicidal patients.

Conclusion: Age and sex are the factors associated with caregivers’s attitudes toward suicidal patients. Nurses can consider these factors into nursing intervention when they are taking care of patients who attempted suicide.