A cross-sectional study on associations of physical symptoms, health self-efficacy and suicidal ideation among Chinese hospitalized cancer patients following diagnosis.

Background: To examine the association between physical symptoms and suicidal ideation among Chinese hospitalized cancer patients post-diagnosis, and test the modifying effect of health self-efficacy on this association. Methods: A cross-sectional study was conducted among 544 cancer patients from oncology setting in two general hospitals in northeastern China. Suicidal ideation data was collected by face-to-face interview using the Yale Evaluation of Suicidality scale (YES). Patients also rated on the McGill Quality of Life Questionnaire (MQOL), the Hamilton Depression Rating scale (HAMD-17) and the Strategies Used by People to Promote Health scale (SUPPH). Multivariable logistic regression was applied to examine the impact of physical symptoms, health self-efficacy and their interactions on suicidal ideation. Results: We found a suicidal ideation rate of 26.3% in patients following cancer diagnosis. Logistic regression showed that insomnia (aOR=1.84, 95% CI 1.13 to 3.00, p =0.015), lack of appetite (aOR=2.14, 95% CI 1.26 to 3.64, p =0.005) were significantly associated with suicidal ideation, low health self-efficacy showed a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p =0.053), even after controlling socio-demographic, clinical characteristics and depression. Conclusions: Insomnia, loss of appetite, even after adjusting depression, are associated with suicidal ideation, health self-efficacy play a moderating role on pain and suicidal ideation among Chinese cancer patients. Paying attention to these physical symptoms and promoting the sense of health self-efficacy could be useful for suicide intervention.