生活品質與自殺相關性之研究：以台灣新兵族群為例

Relationship Between Quality of Life and Suicidality: A Case　Study of Military Conscripts in Taiwan

目的：生活品質的改變與自殺或自傷等相關危險息息相關；然而，台灣為一個徵兵制國家，年滿18歲的男性都必須服兵役，當他們從孰悉的生活環境轉換到一個較為權威的軍事化管理，顯示他們得接受正在轉變的生活環境。因此，改善新兵生活品質理應可以作為軍中自殺防治的一環；然而實際的效用仍未明。方法：作者在2013年3月至6月於北區新訓中心檢視新兵自殺相關問題，並研究其與生活品質之間的相關性，樣本數為688人，取樣時機是新兵入伍受訓後一至二週之間。受試者在接受新兵正常教育課程並經過醫師解釋後，依其意願填寫“成人自填量表”（Adult Self-Report Scale Inventory; ASRI）及台灣簡明版世界衛生組織生活品質問卷（the World Health Organization's WHO Quality of Life-BREF; WHOQOL-BREF）且由受試者自由選擇是否提供自身相關內外科與精神科過去病史。結果：在校正過年齡、教育程度、注意力不足過動症病史、意外事件後，所有的生活品質（包含身體、心理、社會及環境方面）都與自殺有負相關，如可能自殺企圖、可能自我傷害及可能自殺意念。可能自殺意念與可能自殺企圖組的生活品質都表現出較差的生理及心理狀態。可能自我傷害組則在心理與社會關係分數上較差。結論：整體而言，改善新兵特定的生活品質項目，可能可以有效的減少自殺風險，包括可能自殺意念、可能自我傷害、可能自殺企圖等，而針對不同自殺類型所應重視之生活品質類型也應有不同。

Purpose: Given the strong link between quality of life (QOL) and suicidality, it is reasonable to hypothesize that a policy aimed at improving QOL could reduce suicide risk in a population of military conscripts. At present, however, the efficacy that such a policy might have in practice remains unknown. Methods: For this study, a self-administered survey of current QOL and suicidality was conducted among 688 military recruits from a military training center in Northern Taiwan from March 2013 to June 2013. During the first two weeks of their training course, participants were asked to fill out an Adult Self-Report Scale Inventory (ASRI) and the World Health Organization Quality of Life (WHOQOL)-BREF. In addition, participants were asked, but not required, to provide a medical history of physical and/or psychiatric illnesses. Informed consent was obtained for all participants. Results: The results showed that all physical, psychological, social, and environmental QOL indicators are negatively associated with suicidal ideation, attempted suicide, and deliberate self-harm. Participants who reported suicidal ideation and attempted suicide were more likely to have a lower physical and psychological QOL. Participants who reported deliberate self-harm, on the other hand, were more likely to have a lower psychological and social QOL. Conclusion: We conclude that effective suicide prevention for specific subgroups is needed by adopting a specific intervention aimed at different aspects of QOL, especially for individuals who have engaged in deliberate self-harm.