綜合病院 入院患者의 自殺에 對한 考察

Suicide Among General Hospital Inpatients

This study comprises seven suicidal patients occurred at a certain general hospital in Seoul during one and h a lf from Feb. 1979 to Aug. 1980. For the purpose o f finding the possibility of suicidal prevention, this study examined the patients’ psychological state and .emotional response to disease from the nursing charts and interview with assigned nurses. Through this process, it was noted that： (1) During that time, the suicidal rate of whole inpatients was 21.4 among 100,000 inpatients and that of general ward excluding psychiatric ward was 15.6. The rates were higher than those of foreign countries. Most of the cases (6/7) were male. (2) Five of seven suicidal patients, all of whom were nonpsychiatric patients, showed hopelessness. Four of seven showed restlessness and three depressive mood. The hopeless ness was the significant index of suicidel proness in nonpsychiatric patients. Two of four nonpsychiatric male patients complained of loss of ability in work, fear of future, and loss of capacity to support family because of physical illness. These were significant causes of suicidal intent of man. (3) There were in sufficient observations of psychopathology, psychiatric approach to patients and record of nursing chart about the patients responses to disease in nonpsychiatric ward. There was only one psychiatric consultation (20%) among the five nonpsychiatric patients. Cases without psychiatric consultation were not given pertinent observation and necessary treatment for their psychiatric problems. (4) Five of six nurses answered that it was impossible for them to prevent suicide. But only one said that it would be possible to prevent if she had paid more attention at that time. (5) Only one of seven suicidal patients took legal proceeding. The remaining Gpatients had had hopeless illnesses, histories of previous suicidal attempts and had no family member keeping at bed-side at the time of suicide. Family members’ easier acceptance of the death and their guilt seemed to have prevented litigations. (6) If patients were in terminal state and suffered hopelessness and severe physical discomfort the therapists had better observe the patients’ psychological state and emotional response to illness and give emotional support to their patients. It may be also helpful to predict and prevent suicide if the therapists explain to the family about the patients’depressive mood and hopelessness and it is also recommended to open the nursing system for the purpose of taking care of suicide prone patients.