Suicidal ideation and influencing factors among hospitalized older adults with functional impairments: a mixed-methods study.

BACKGROUND

Compared to their healthy counterparts, hospitalized older adults with functional impairments face a heightened risk of suicidal ideation due to disease-related pain, loss of independence, and reduced social engagement, positioning them as a high-risk demographic for suicide. However, extant research has predominantly focused on generally healthy older populations, leaving a significant gap regarding those with substantial functional limitations. This study aims to investigate the prevalence and influencing factors of suicidal ideation among hospitalized older adults with functional disabilities.

METHODS

We conducted a two-part mixed-methods study. After hospital manager approval, we surveyed the suicide ideation of 717 hospitalized older adults with functional impairments. We carried out participatory observation with 4 hospitals and semi-structured interviews with 10 hospitalized older adults with functional impairments to elicit detailed information on the process leading to suicidal ideation.

RESULTS

The prevalence of suicidal ideation among hospitalized older adults with functional impairments was notably high (17.4%). The quantitative and qualitative findings corroborate and complement each other. Factors significantly associated with suicidal ideation (p < 0.05) included lower monthly income, bad family relationships, high experiential avoidance, high depressive symptoms, and low resilience. Through qualitative analysis, three overarching categories of influencing factors were identified: vulnerability factors, risk factors, and protective factors.

CONCLUSIONS

Given the high prevalence of suicidal ideation among hospitalized older adults with functional impairments, it is imperative for healthcare professionals to prioritize monitoring those with identified vulnerability factors, promptly recognize emerging risk factors, and actively leverage protective factors to implement tailored interventions aimed at mitigating suicidal ideation.