International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 9, Issue 1, pp: (126-132), Month: April 2021 - September 2021, Available at: www.researchpublish.com
A Multi - Level Analysis on Assessment of Different Dimensions of Suicidality among Adults in Batticaloa District, Sri Lanka Kartheepan, K1# 1
Senior Lecturer in Community Medicine, Department of Primary Health Care, Faculty of Health-Care Sciences, Eastern University, Sri Lanka. (kartheepank@esn.ac.lk)
Abstract: Background: Suicidal behaviours, ranging from suicidal ideation to suicidal acts, such as quasi-suicide, attempted suicide, and completed suicide, are very common and have reached a very wide range. In addition, this is a complex issue. Therefore, it must be investigated from multiple levels. Objective: This study focused on assessing suicidality with different dimensions among adults in the Batticaloa district of Sri Lanka (BDSL). Methodology: A cross-sectional study was carried out with 237 male and female patients of medical wards of Base Hospital, Kaluwanchikudy (BHK), from 1st January to 31st May 2019. A two-stage cluster sampling method was applied. Structured Interviewer Administered Questionnaire (SIAQ) and the Revised Suicide Behaviour Questionnaire (SBQR) are used to obtain the determinants of the various dimensions of suicide. Statistical software (SPSS 25.0) was used to analyze the data, and p-value < 0.05 was considered significant for all analyses. Descriptive statistical analysis and Multi-Level Analysis (MLA) was performed. Ethical approval was obtained from the Ethical Review Committee, Faculty of Health - Care Sciences, Eastern University, Sri Lanka. Results: 21.5% of the participants had at least one relative who attempted suicide, and almost all of them died. Few patients (6.8%) in this survey had attempted suicide and were lucky to get rid of the deadly outcome. Among these suicide attempts, the majority (73.5%) answered that their lives are vital to surviving these attempts. Variance in the total score for the suicide behaviour questionnaire is estimated as = 7.13, and the between-individual patient's variance is calculated as =2.52, and thus the total variance is 7.13 + 2.52 = 9.65. Overall mean value on the total score for suicide behaviours questionnaire across three different levels (No, definitely not, Maybe and Yes definitely) of choices of the question: would any of your problems be solved if you committed suicide? is estimated as 6.95, which was statistically significant. Conclusions: Three different levels of responses (No, definitely not, Maybe and Yes definitely) significantly varied for the scores of Suicide Behaviours Questionnaire-Revised (SBQ-R)-Overview. Overall, there was 29.4 times greater variance observed in three different choices (three different levels) for Q15 than the variance among individual patients regarding the total score for the suicide behaviour questionnaire with statistical significance. Keywords: Adults, Batticaloa, Sri Lanka, Suicides, Multi-Level Analysis.
1. INTRODUCTION Suicidality encompasses suicidal ideation (serious thoughts about suicide), a suicide plan, and a suicide attempt. People who have suicidal ideas and a suicide plan are at a higher risk of attempting suicide, while those who have experienced various forms of suicidal thoughts and behaviours are at a higher risk of completing suicide. In adolescents, suicidal ideation has been reported as an essential risk factor for suicide and associated with a subsequent risk of attempting suicide [20]. Suicide-related behaviours are a significant public health problem, and these behaviours have increased significantly globally in recent decades. Suicide-related behaviours are complex, multidimensional events with multiple behavioural characteristics, including a series of self-injurious thoughts and behaviours to die [19]. Less obvious signs may include insomnia or changes in sleep patterns, unexplained changes in weight or appetite, changes in personality or attitude, irritability or crying, inability to concentrate or reason, sudden changes in appearance, sudden changes and Unexpected Well-being and Depression [14]. The study conducted by Johal, D.S and Sharma, M in 2016 pointed out that
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