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Suicidal Ideation and Psychological Strain Among Patients Diagnosed With Stomach Cancer: The Mediation of Psychopathological Factors

Zhang, Xuekun PhD (Cand)*†; Zhang, Jie PhD‡§; Procter, Nicholas RN, MBA, PhD; Chen, Xiaoyun MMed*; Su, Yonggang MD*∥; Lou, Fenglan BMed*; Cao, Fenglin PhD*

The Journal of Nervous and Mental Disease: July 2017 - Volume 205 - Issue 7 - p 550–557
doi: 10.1097/NMD.0000000000000679
Original Articles

Patients with stomach cancer are at high risk to experience suicidal ideation. Strain theory of suicide assumes that suicide is preceded by psychological strain. Despite wide international acceptance of the theory, its use with a sample of patients with stomach cancer has not previously been reported. The aims were to examine the relationship between psychological strain and suicidal ideation among patients with stomach cancer and to determine whether psychopathological factors act as mediators. A cross-sectional study was undertaken involving subjects with no history of mental disorder, and questionnaires were administered by face-to-face interview. Patients who experienced more psychological strain, especially coping strain, are more likely to experience suicidal ideation. The mediation effects of hopelessness and psychological distress are significant. Psychological strain, hopelessness, and psychological distress may be the vital factors among patients with stomach cancer in the suicide-risk assessment interview and for care planning and psychological intervention.

*School of Nursing, Shandong University, Jinan, Shandong, China; †School of Nursing and Midwifery, University of South Australia, Adelaide, Australia; ‡Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China; §Department of Sociology, State University of New York College at Buffalo, Buffalo, NY; and ∥School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China.

Send reprint requests to Fenglin Cao, PhD, School of Nursing, Shandong University, No. 44 Wenhua Xi Rd, Jinan, Shandong, 250012, China. E-mail:

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