사회적환경요인과 자살손상중증도 사이의 관련인자 연구
A study for the socio-environmental factors
초록/요약
Suicide survivors are often left with worse physical and economic conditions after their suicide attempt than before. A greater severity of suicide-related injuries is associated with worse physical and economic conditions, and suicide survivors are highly likely to re-attempt suicide out of despair regarding their situation. In addition, suicidal behavior leads to socioeconomic loss beyond personal loss. Recently, all the reported suicide-related risk factors have been suggested to have little explanatory strength - or to be incorrect. Since suicide is a phenomenon triggered by the social environment, a nation—the largest unit of the society—is responsible for managing (based on evidence) the issue of suicide. Unlike previous studies, this study aimed to identify socio-environmental factors influencing the severity of suicide-related injuries that can impact the physical and economic conditions of suicide survivors. This study also aimed to provide basic data for planning suicide-related projects at government and municipal levels. Information on patients hospitalized after a suicide attempt was obtained from the 2014 National Hospital In-Depth Injury Survey data (published in 2015), and the ICE-ICISS values were used to analyze the severity of suicide-related injuries. Socio-environmental factors were selected among all statistical indices contained in “statistics by topic”, ii “statistics by agency” and “E-local statistics” published by the National Statistical Office. The influence of these factors was identified using a complex sampling design. The explanatory strength of the model—which included influencing factors of sex, age, the source of payment, and the mechanism of injury sustained—was 52.9%. Mining (β=-2.340, p<.05) and local emergency medical institutions (β=-0.162, p<.05) were found to increase the severity of the suicide-related injuries. In order to reduce the severity of suicide-related injuries, it is necessary to improve local emergency medical institutions and related systems, and to continuously manage community residents’ underlying vulnerability to suicide. In particular, such efforts may be needed more at the regional level.
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Abstract i
Ⅰ. INTRODUCTION 1
A. Background and necessity of the study 1
B. Objectives 6
Ⅱ. MATERIALS AND METHODS 7
A. Study design 7
B. Subjects and data collection 8
1. Suicidal patient data 9
(A) The Korean National Hospital Discharge In-depth Injury Survey(KNHDIIS) database 9
(B) ICISS and ICE-ICISS 10
2. Socio-environmental factors 12
(A) Socio-environmental factors (Index of Statistics Korea) 12
(B) Postal code 32
C. Methods 33
1. Data processing 33
2. Data analysis 33
Ⅲ. RESULTS 36
A. Characteristics of the subjects and socio-environmental factors 36
B. Comparison of mean ICISS according to demographics 43
C. Correlations between the ICISS and the general characteristics of the subjects and socio-environmental factors 45
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D. Effect of socio-environmental factors on the ICISS 49
E. Effect of socio-environmental factors on the ICISS after controlling for human factors 51
Ⅳ. DISCUSSION 54
Ⅴ. CONCLUSION 65
REFERENCES 66
Appendix 74
1. The Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) (Korean) 74
2. Socio-environmental factors put into research list (Korean) 76
국문요약 81
