Abstract
Aim: To develop a Cancer Patient Suicidal Ideation Scale (CAPASIS) and test its reliability and validity. Patients & methods: An initial CAPASIS was developed. Clinical assessment was conducted using an adjusted initial scale with 239 cancer patients for item reduction and 253 for scale validation. Results: Item selection analyses resulted in 22 items. The revised model fits were acceptable (normal chi-square [χ2/df] = 1.919; standardized root mean residual = 0.057; root mean square error of approximation = 0.060; goodness fit index = 0.882; adjusted goodness fit index [AGFI] = 0.844; Tucker–Lewis index = 0.898; comparative fit index = 0.915; incremental fit index = 0.917). The Cronbach's alpha coefficient was 0.911. Conclusion: The CAPASIS has good validity and reliability, with a six-factor structure of ‘entrapment’, ‘defeat', ‘isolation', ‘hopelessness', ‘burdensomeness' and ‘humiliation', which can help identify patients with suicidal ideation.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1. . Suicide and self-harm. Lancet 399(10338), 1903–1916 (2022).
- 2. Cancer diagnosis and suicide outcomes: umbrella review and methodological considerations. J. Affect. Disord. 295, 1201–1214 (2021).
- 3. Incidence of suicide death in patients with cancer: a systematic review and meta-analysis. J. Affect. Disord. 276, 711–719 (2020).
- 4. Suicide risk and mortality among patients with cancer. Nat. Med. 28(4), 852–859 (2022).
- 5. . A network meta-analysis of stress mediators in suicide behaviour. Front. Neuroendocrinol. 63, 100946 (2021).
- 6. . Suicide and cancer: where do we go from here? Crit. Rev. Oncol. Hematol. 78(3), 206–219 (2011).
- 7. . Suicide, suicide attempts, and suicidal ideation. Annu. Rev. Clin. Psychol. 12, 307–330 (2016). • Defines differences between suicidal behaviors.
- 8. . Is suicidal behaviour a stronger predictor of later suicide than suicidal ideation. A systematic review and meta-analysis. Aust. N. Z. J. Psychiatry 55(3), 254–267 (2021).
- 9. Suicide and suicide risk. Nat. Rev. Dis. Primers. 5(1), 74 (2019).
- 10. The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients. J. Psychosoc. Oncol. 38(5), 612–626 (2020).
- 11. . Suicidal ideation, distress, and related factors in a population of cancer patients treated in a general acute hospital. Support. Care Cancer 30(1), 487–496 (2022).
- 12. Association between social support and suicidal ideation in patients with cancer: a systematic review and meta-analysis. Eur. J. Cancer Care. (Engl.) 30(2), e13382 (2021).
- 13. . Magnitude and associated factors of suicidal ideation among cancer patients at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia, 2019: cross-sectional study. Cancer Manag. Res. 13, 4341–4350 (2021).
- 14. . The interpersonal theory of suicide. Psychol. Rev. 117(2), 575–600 (2010). • A theory describing the formation of suicidal ideation.
- 15. . The integrated motivational-volitional model of suicidal behaviour. Philos. Trans. R. Soc. Lond. B Biol. Sci. 373(1754), 20170268 (2018). • A theory describing the formation of suicidal ideation.
- 16. . The three-step theory of suicide: description, evidence, and some useful points of clarification. Prev. Med. 152(Pt 1), 106549 (2021). •A theory describing the formation of suicidal ideation.
- 17. . Incidence and risk factors of suicide in patients with lung cancer: a scoping review. Support. Care Cancer 30(4), 2945–2957 (2022).
- 18. Risk factor analysis and nomogram construction for predicting suicidal ideation in patients with cancer. BMC. Psychiatry 22(1), 353 (2022).
- 19. . Suicidal ideation in patients with cancer: a systematic review of prevalence, risk factors, intervention and assessment. Palliat. Support. Care. 18(2), 206–219 (2020). •• Clarifies existing suicidal ideation measurement tools.
- 20. . Assessment of suicidal intention: the Scale for Suicide Ideation. J. Consult. Clin. Psychol. 47(2), 343–352 (1979).
- 21. . The interference in the suicide ideation of patients with malignant tumors by mental clinical nursing pathway. Patient Prefer. Adherence 8, 1665–1669 (2014).
- 22. . Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide Life Threat. Behav. 34(4), 350–362 (2004).
- 23. . Predictive validity of the Chinese version of the Adult Suicidal Ideation Questionnaire: psychometric properties and its short version. Psychol. Assess. 19(4), 422–429 (2007).
- 24. . Assessing Chinese older adults' suicidal ideation: Chinese version of the Geriatric Suicide Ideation Scale. Aging Ment. Health 9(2), 167–171 (2005).
- 25. . Sample size in factor analysis. Psychol. Methods 4(1), 84–99 (1999).
- 26. . Development of a scale for determining violence against infertile women: a scale development study. Reprod. Health 11(1), 18 (2014).
- 27. . The selection of upper and lower groups for the validation of test items. J. Educ. Psychol. 30(1), 17–24 (1939).
- 28. . Generalized discrimination index. Int. J. Educ. Methodol. 6(2), 237–257 (2020).
- 29. . Assessing model fit: caveats and recommendations for confirmatory factor analysis and exploratory structural equation modeling. Meas. Phys. Educ. Exerc. Sci. 19(1), 12–21 (2015).
- 30. Childbirth Readiness Scale (CRS): instrument development and psychometric properties. BMC Pregnancy Childbirth 22(1), 257 (2022).
- 31. . The impact of cultural collectivism on knowledge sharing among information technology majoring undergraduates. Comput. Human Behav. 56, 65–71 (2016).
- 32. . Psychosocial characteristics of individuals with non-stage IV melanoma. J. Clin. Oncol. 19(11), 2844–2850 (2001).
- 33. . Patterns of coping with cancer. Health Psychol. 11(2), 79–87 (1992).
- 34. . Coping strategies and psychological distress in patients with advanced cancer. Oncol. Nurs. Forum 26(9), 1511–1518 (1999).
- 35. The mediating role of avoidant coping in the relationships between physical, psychological, and social wellbeing and distress in breast cancer survivors. Psychooncology 30(7), 1129–1136 (2021).
- 36. . ‘Sometimes I can't look in the mirror’: recognising the importance of the sociocultural context in patient experiences of sexuality, relationships and body image after ovarian cancer. Eur. J. Cancer Care (Engl.) 31(6), e13645 (2022).
- 37. . Correlates of stigma for patients with cancer: a systematic review and meta-analysis. Support. Care Cancer 29(3), 1195–1203 (2021).
- 38. . Making sense of Cronbach's alpha. Int. J. Med. Educ. 2, 53–55 (2011).
- 39. . Short-term change and prediction of suicidal ideation among adolescents: a daily diary study following psychiatric hospitalization. J. Child. Psychol. Psychiatry 60(7), 732–741 (2019).
- 40. Understanding the basis of major depressive disorder in oncological patients: biological links, clinical management, challenges, and lifestyle medicine. Front. Oncol. 12, 956923 (2022).